Selective Serotonin Reuptake Inhibitors and Cataract Risk

Journal Highlights

Do the class of antidepressants known as selective serotonin reuptake inhibi­tors (SSRIs) raise cataract risk? While recent population-based studies from Canada and the United States suggest that they do, Becker et al. quantified the risk of cata­ract among patients exposed to SSRIs and found mixed results, with a slight increase in risk observed only among those between the ages of 40 and 64.

The researchers drew their study population from the U.K.–based Clinical Practice Research Datalink (CPRD) and included 206,931 adults with first-time cataract (≥ 40 years of age) and an equal number of cata­ract-free controls matched for age, sex, date of cataract recording (index date), and number of prior years in the CPRD. The mean age at index date was 73.7 years. Those with a previous diagnosis of glaucoma were excluded from sensitivity analyses.

The number of prescriptions for SSRIs and other antidepressant drugs was noted, as was the exclusive use of a single SSRI. The researchers performed logistic regression analyses, adjusting for body mass index, smoking status, presence of diabetes or hypertension, and use of systemic steroids. For sen­sitivity analyses, they shifted the index date backward 2 years to account for latency of cataract recording and to ensure that the antidepressant exposure occurred before the cataract.

Overall, current long-term use of SSRIs (≥ 20 prescriptions [courses of treatment]) was not associated with elevated risk of cataract, and results for men and women were similar. However, among those in the 40-64 age group, cataract risk was slightly higher for long-term SSRI users than for nonusers. Although diabetes or cardiovascular disease increased cataract risk, smoking and obesity did not. No increase in cataract risk was found for patients who used a single type of SSRI exclusively.